Position Statement: Effective referrals

Dying With Dignity Canada (DWDC) strongly encourages all provincial/territorial regulatory bodies to consider the needs, and end-of-life wishes, of all patients and follow the lead of the Colleges of Physicians and Surgeons in Ontario, British Columbia and Nova Scotia, all of which have policies that compel regulated members to provide an effective referral or effective transfer of care. (It is important to note that in Ontario, the College of Physicians and Surgeons of Ontario’s effective referral policy was challenged by the Christian Medical and Dental Society of Canada, but was upheld by the court because it was found to serve the important social and public benefit of ensuring equitable access to health care.) 

We recognize and support the individual rights of clinicians to object, for conscience reasons, to providing medical assistance in dying (MAID) or other medical treatments. Similarly, patients have the right to access health care in a timely manner. The burden of self-referral can result in delays in accessing time-sensitive medical care, particularly for vulnerable patients.  

An effective referral does not guarantee a patient will receive a treatment, nor does it signal that the objecting health care provider endorses or supports the treatment. An effective referral strikes a balance between a clinician’s conscientious objection to a treatment and a patient’s right to health care, and most importantly ensures that access to care is continuous and non-discriminatory.  


College of Physicians and Surgeons of Ontario effective referral policy – https://www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Professional-Obligations-and-Human-Rights/Advice-to-the-Profession-Professional-Obligations  

College of Physicians and Surgeons of British Columbia access to medical care without discrimination practice standard – https://www.cpsbc.ca/files/pdf/PSG-Access-to-Medical-Care.pdf  

College of Physicians and Surgeons of Nova Scotia (CPSNS) Professional Standard Regarding Transfer of Care – https://cpsns.ns.ca/wp-content/uploads/2017/10/Transfer-of-Care.pdf  

CPSNS Professional Standard Regarding Medical Assistance in Dying (MAID) – https://cpsns.ns.ca/resource/medical-assistance-in-dying/#_ftnref2 

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